The effect of positive-end-expiratory pressure on stroke volume variation: An experimental study in dogs

Tsuyoshi Nakashima, Yu Kawazoe, Toshie Iseri, Kyohei Miyamoto, Yuka Fujimoto, Seiya Kato

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Stroke volume variation (SVV) may be affected by ventilation settings. However, it is unclear whether positive-end-expiratory pressure (PEEP) affects SVV independently of the effect of driving pressure. We aimed to investigate the effect of driving pressure and PEEP on SVV under various preload conditions using beagle dogs as the animal model. We prepared three preload model, baseline, mild and moderate haemorrhage model. Mild and moderate haemorrhage models were created in nine anaesthetized, mechanically ventilated dogs by sequentially removing 10 mL/kg, and then an additional 10 mL/kg of blood, respectively. We measured cardiac output, stroke volume (SV), SVV, heart rate, central venous pressure, pulmonary capillary wedge pressure and the mean arterial pressure under varying ventilation settings. Peak inspiratory pressure (PIP) was incrementally increased by 4 cmH2O, from 9 cmH2O to 21 cmH2O, under PEEP values of 4, 8, and 12 cmH2O. The driving pressure did not significantly decrease SV under each preload condition and PEEP; however, significantly increased SVV. In contrast, the increased PEEP decreased SV and increased SVV under each preload condition and driving pressure, but these associations were not statistically significant. According to multiple regression analysis, an increase in PEEP and decrease in preload significantly decreased SV (P <.05). In addition, an increase in the driving pressure and decrease in preload significantly increased SVV (P <.05). Driving pressure had more influence than PEEP on SVV.

Original languageEnglish
Pages (from-to)1014-1019
Number of pages6
JournalClinical and Experimental Pharmacology and Physiology
Volume47
Issue number6
DOIs
Publication statusPublished - 2020 Jun 1
Externally publishedYes

Keywords

  • driving pressure
  • fluid responsiveness
  • peak inspiratory pressure
  • positive-end expiratory pressure
  • stroke volume
  • stroke volume variation

ASJC Scopus subject areas

  • Physiology
  • Pharmacology
  • Physiology (medical)

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